Understanding neuromodulation of the Stroke Brain using tCMS - A pilot study

Abstract

Even though the mortality rate of strokes has decreased in the past few decades, the number of disability adjusted life year shas increased due to the permanent motor damage left in stroke survivors even after extensive physical therapy. rTMS treatments such as cTBS have had a rise in popularity in recent years and show much promise in the treatment of stroke patients. There are still many unknowns, however, about the effects of rTMS on interhemispheric inhibition and its underlying mechanisms. Therefore our UNOS pilot study was aimed at elucidating these unknowns by testing the effect of cTBS treatment on 10 healthy volunteers and assessing its effect on interhemispheric inhibition and how it relates to handedness. We used two figure-of-eight in a double pulse paradigm in order to stimulate the motor cortex of 10 healthy participants and to assess IHI values at two timepoints. Before and after cTBS treatment. Our results seem to suggest an association between motor control and the transition from interhemispheric inhibiton to facilitation at movement onset, the mean IHI values for the left-right and right-left CS-TS directions were 1.63 and 2.95 respectively. However, this difference is not significant with a P value of 0.058. Our results have also shown that there is a very high interpersonal variability between participants in the effect elicited by cTBS, therefore limiting generalisation of cTBS treatment. This underlines the need for more personalised treatments and the need for more diagnostics before treamtents.